Independence Healthcare PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

INDEPENDENCE HEALTHCARE PC

Practice address

100 Trading Bay Rd Ste 8
Kenai, AK 99611-7786

Phone

(907) 283-4633

Fax

(907) 262-0832

NPI assigned

Jan 3, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Henry G Krull

Title

MD/Owner

Phone

(907) 262-6454

Specialties & licenses 1

Addresses

Other names 1

• Independence Healthcare Primary Care Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582588800000",
    "number": "1124667498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 N FIREWEED ST",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697540",
            "telephone_number": "907-262-6454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TRADING BAY RD STE 8",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117786",
            "telephone_number": "907-283-4633",
            "fax_number": "907-262-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE HEALTHCARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-03",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A",
        "authorized_official_last_name": "KRULL",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "907-262-6454"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Independence Healthcare Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Independence Healthcare Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kirsten L Huntsman
• Sarah Huot, OTR/L
• Ann Kathryn-Meyer Hupe, DO
• Ideal Option, PLLC
• Dalanie B Inama
• Independence Healthcare PC
• Inner Strength Counseling, LLC
• Joan C Itano Merrick, ANP
• Jac Enterprises, Inc.
• Joann Lee Jackinsky

• Family Medicine Physician in Kenai, AK
• Providers in Kenai, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.